Provider Demographics
NPI:1902157498
Name:VHS PHYSICIANS OF MICHIGAN
Entity Type:Organization
Organization Name:VHS PHYSICIANS OF MICHIGAN
Other - Org Name:DMC MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-665-6318
Mailing Address - Street 1:4707 SAINT ANTOINE ST
Mailing Address - Street 2:SUITE 516
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48201-1427
Mailing Address - Country:US
Mailing Address - Phone:313-993-6080
Mailing Address - Fax:313-993-6099
Practice Address - Street 1:2300 HAGGERTY RD
Practice Address - Street 2:SUITE 2120
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48323-2184
Practice Address - Country:US
Practice Address - Phone:248-960-7711
Practice Address - Fax:248-960-7722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-25
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301041239207R00000X
MI4301053306207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MID72716Medicare UPIN
MIF62733Medicare UPIN